CSC Options Tab - Options and Settings

CSC Tab Options	Option	Description
Consolidated Services Claim payment Posting	Enable Posting to CSC Claims	Enables matching logic for the following 835 segments during the ERA Posting process: REFEA Segment REF01 (2100 level)-EA - Medical Record Identification Number identifies the CSC Claim from the superclaim_encounters table. REFEA - the REF6R line item control number is used to match to the service line(s) for ERA posting. REF6R - is used for UB/837I posting of CSC and Non-CSC Claim payments. On the Default tab, in the Charge Matching Options, you must select Use Bundled Payment Processing for UB Claim to this segment. REFEA - If not returned , the 2100 Service Lines REF6R is used to look for a match. REF6R - identifies a match to a CSC Claim, each payment’s line item is posted to the matching REF6R. REFEA and REF6R - are missing, the normal Remittance Profile Settings will be used.
When option is disabled	When the option is disabled, and the payment is matched as a CSC claim payment, the payment will not post. The ERA Import Posting report, you receive a message that the payment has not posted because of how it is configured.
CSC Claim Level Payments and Adjustments - 1500 and UB	Distribute Claim-Level Payments - 1500	Select one of the following options: Apply to remaining line item balance FIFO Weighted
Distribute Claim-Level Adjustments - 1500	Select one of the following options: Apply to remaining line item balance FIFO Weighted
Distribute Claim-Level Payments - UB	Select one of the following options: Apply to remaining line item balance FIFO Weighted
Distribute Claim-Level Adjustments - UB	Select one of the following options: Apply to remaining line item balance FIFO Weighted
CSC Claim Level Transaction Codes	CSC Payment Transaction Code	Select a payment transaction code to be used for CSC claim-level payments. Note: When this field is blank, the transaction code in the Default Payment field in the Payer > Practice > Transactions is used.
CSC Adjustment Transaction Code	Select an adjustment transaction code to be used for CSC claim-level adjustments. Note: When this field is blank, the transaction code in the Default Adjustment field in the Payer > Practice tab > Transactions is used.

Help Guide for NextGen® Enterprise PM 8

Set Up the Remittance Profile - CSC Options Tab

The CSC Options tab in the Remittance Profile library is used to set options for handling ERA transactions for services that were combined for the same patient on the same day through the Consolidated Services Claim process. Note: The CSC Options tab is available when a Consolidate Services Claim library is attached in Practice Preferences > Libraries. To set up the CSC Options tab in a Remittance Profile library, do the following: Open File Maintenance. Select Libraries, and then select Remittance Profiles. The Remittance Profiles List window opens. Open the profile library. The Remittance Profile window opens. Select the CSC Options tab. Select settings for CSC options. When you're done setting options, select OK to save changes and close the window. CSC Options Tab - Options and Settings Parent topic: Set Up a Remittance Profile Library

File Maintenance Help for NextGen® Enterprise 8

CSC Options Tab - Options and Settings

You can use the following list of options and descriptions to make settings on the CSC Options tab in your Remittance Profile. CSC Tab Options Option Description Consolidated Services Claim payment Posting Enable Posting to CSC Claims Enables matching logic for the following 835 segments during the ERA Posting process: REF*EA Segment REF01 (2100 level)-EA - Medical Record Identification Number identifies the CSC Claim from the superclaim_encounters table. REF*EA - the REF*6R line item control number is used to match to the service line(s) for ERA posting. REF*6R - is used for UB/837I posting of CSC and Non-CSC Claim payments. On the Default tab, in the Charge Matching Options, you must select Use Bundled Payment Processing for UB Claim to this segment. REF*EA - If not returned , the 2100 Service Lines REF6R is used to look for a match. REF6R - identifies a match to a CSC Claim, each payment’s line item is posted to the matching REF*6R. REF*EA and REF*6R - are missing, the normal Remitt

Help Guide for NextGen® Enterprise PM 8

Bundled Payments

For bundled payments, the ERA Import Posting report functions as described below: If an Encounter Level Payment Distribution method is not selected in the Remittance Profile library, the ERA Import Posting report displays the following message: "Bundled payment was not posted because Encounter Level Distribution method was not enabled in the Remittance Profile". Note: The ERA Posting process cannot post bundled payments unless an Encounter Level Payment Distribution method has been selected in the Remittance Profile. If the claim is UB/837I and no claim was found for the encounter of the NU bundled payment, the ERA Import Posting report displays the following message: "Bundled payment was not posted because no claim was identified for this encounter". If the claim is UB/837I and no match was found for the NU bundled payment, the ERA Import Posting report displays the following message: "Bundled payment was not posted because no charge match was found for this revenue code". If the clai

Help Guide for NextGen® Enterprise PM 8

Reporting Bundled Payments

The table below outlines how the ERA Import Posting report handles bundled payments. If... Then the ERA Import Posting Report displays the following message: No Encounter Level Payment Distribution method is selected in the Remittance Profile "Bundled payment was not posted because Encounter Level Distribution method was not enabled in the Remittance Profile". Note: To post bundled payments, you must select the Encounter Level Payment Distribution method in the Remittance Profile. The claim is UB/837I and no claim was found for the encounter of the NU bundled payment "Bundled payment was not posted because no claim was identified for this encounter". The claim is UB/837I and no match was found for the NU bundled payment "Bundled payment was not posted because no charge match was found for this revenue code". The claim is NU and a match was found for the NU bundled payment, but the balances of the charges are 0 or credit "Bundled payment was not posted. Charge match(es) found for this r

Help Guide for NextGen® Enterprise PM 8

ERA Posting to the Post to Voided Charge

You can post an ERA transaction to the voided charge when the Post to voided charge option is selected on the Remittance Profile window and the encounter has no active charge. When the same CPT® code is rebilled for a charge, the application does not match with the voided CPT code and instead looks for the next active CPT code. Negative billed line items are not considered while posting to voided charges. The following table describes the different settings and results for posting the ERA payment to Post to voided charge. Post to voided charge (Enabled/Disabled) Ignore Claim ID Nbr matching (Enabled/Disabled) Ref*6R segment in ERA file Encounter Charge (Active/Voided) Result Disabled Enabled Present or Absent Active and Voided charge The transaction is posted to the active charge, as the Ref*6R segment may or may not be present in the ERA file, the encounter has an active charge, and the Post to voided charge option is disabled. Disabled Enabled Present or Absent Voided charge The tran

Help Guide for NextGen® Enterprise PM 8

Posting Logic for Bundled and Unbundled Payments

You can post bundled and unbundled ERA payments for professional or institutional claims. Bundled payments are single ERA payments remitted for multiple charge lines. Unbundled payments are multiple ERA payments remitted for a single charge line with a quantity greater than one. The following table describes the various settings and their results for an ERA file. Encounter Charge Remittance Profile Library Setting ERA File Result Claim REF*6R Segment SVC Segment Single charge, Quantity >1 Single line, Quantity >1 Enable Post Unbundled Payment to Single Charge Present Unbundled payment (an individual payment per unit) The system posts the allowed amount, payment and adjustment amounts against the single charge using REF*6R and adds the individual transactions as one. Note: The Charge Matching Options configuration in Remittance Profile is not considered when using Post Unbundled Payment to Single Charge option. Single charge, quantity >1 Another single charge where quantity = 1 First li

CSC Options Tab - Options and Settings

Recommendations

Set Up the Remittance Profile - CSC Options Tab

CSC Options Tab - Options and Settings

Bundled Payments

Reporting Bundled Payments

ERA Posting to the Post to Voided Charge

Posting Logic for Bundled and Unbundled Payments

CSC Options Tab - Options and Settings

Set Up the Remittance Profile - CSC Options Tab

CSC Options Tab - Options and Settings

Bundled Payments

Reporting Bundled Payments

ERA Posting to the Post to Voided Charge

Posting Logic for Bundled and Unbundled Payments